Wise Provider Networks

Obtaining quality health care at affordable prices is a priority for everyone in America. At WISE Provider Networks, it is a top priority. At WISE, we’ve teamed up with a wide variety of the finest organizations and companies in Utah. Our clients and health care providers are our partners. We want you to think of us as an extension of their organizations.

WISE Provider Networks represents about 95,000 members in the State of Utah and 15,000 in Wyoming. Included in this group are twelve large Employers or Trust Funds with an average of 3,000 members each. WISE Provider Networks has been formed to contract directly with physicians and hospitals on behalf of these 35,000 members.

WISE has an agreement and the support of the HCA Hospital System, University of Utah Hospitals, University of Utah Medical Group and the IASIS Hospital System in Utah.

Allison Robbins – Managed Care Consultant

Experience/Involvement	Awards
Founded Five-Star Health Solutions: 2002 Vice President Managed Care, HCA the Healthcare Company (MountainStar): 1998-2002 Administered and negotiated contracts affecting $180 million in managed care revenue including Regence BlueCross BlueShield, Altius Health Plans, UnitedHealthcare, Cigna Healthcare, IHC Health Plans, PEHP, DMBA, CCN, and Private Healthcare Systems. Sales Business Manager, PacifiCare of Utah (Now Altius): 1997- 1998 Founded Network Services, Intermountain Health Care: 1993-1997 Administered and negotiated contracts affecting $300 million in managed care revenue including Regence BlueCross BlueShield, Aetna Healthcare, PEHP, DMBA, EMIA, Beech Street and Private Healthcare Systems. Senior Underwriter, IHC Health Plans: 1993-1997 Senior Underwriter, Great-West Life Assurance Company: 1989-1993	1999 Prism Awards: Utah Society of Healthcare Communicators and Planners: Gold Award for Print 2000 Prism Awards: Utah Society of Healthcare Communicators and Planners: Gold Awards for TV and Print 2000 Health Marketing Report: Merit Award for Direct Mail 2001 Health Marketing Report: Silver Award for Logo, Merit Awards and TV Ad Campaign and Print 2002 Prism Awards: Utah Society of Healthcare Communicators and Planners: Gold Award for Print, TV Single and Total Campaign, Silver Award for Print
Expertise
Ten years of broad, high-level managed care experience with a background in senior-level executive contract negotiation, strategic planning and underwriting Pattern of success in maximizing costing savings and increasing access to health care providers Innovative entrepreneurial capabilities that have changed the course of Utah managed care organizations Enjoys activities that include motivating, mediating, selling, influencing, consensus building and persuading

Twinkle Chisholm – Marketing/Communications

Experience/Involvement	Awards
Founded Lucky Dog Communications: 1998 Vice President, Marketing & Communications, HCA the Healthcare Company: 1994-1998 Outreach Coordinator, Breast Care Services, Holy Cross Health System: 1993-1994 Medical Reporter, KUTV: 1989-1993	TV: Emmy Awards, Columbia DuPont, Society of Professional Journalists, Iris Awards, Edward R. Murrow Award, Chicago Film Festival, New York Film Festival, CDC Lucky Dog Communications: Prism Awards (1997, 1998, 1999, 2000, 2001), Healthcare Marketing/Advertising Awards (2000, 2001, 2002, 2003, 2004), Aster Awards (2002, 2003, 2004), Service Industry Advertising Awards (2004) Personal: Lifetime Achievement Awards (2003)
Expertise
Ten years experience in marketing, advertising, public relations and research in the healthcare field Innovative, thinks out-of-the-box to find solutions to clients problems Provides customer service to clients that is unmatched in the industry

Sheryl Dobson – Disease Management

Experience/Involvement	Awards
Founded Dobson and Associates: 1999 Director Utilization Management and Case Management, IHC Health Plans: 1996-1999 Medical Case Manager, LDS Hospital: 1990-1995	Registered Nurse: 1984-2004 Certified Case Manager: 1993 Certified Legal Nurse Consultant: 2003
Expertise
Fifteen years experience with case management and utilization management of high cost claims and catastrophic illness or injury

WISE PROVIDER NETWORKS

CREDENTIALING PROCESS

Wise Provider Networks will process your credentialing file prior to finalizing a contract for participation in the Wise Provider Network. This process can take up to 60 days. The process is typically expedited by the retrieval of credentialing files through CAQH.

CAQH is an online database which gathers provider credentialing information that can be accessed by multiple organizations that choose to participate with CAQH. The service is free of charge to providers and greatly reduces the time-consuming task of completing multiple credentialing applications. To obtain more information about CAQH, please visit www.CAQH.org or click on the following link to access CAQH and set up your account – https://caqh.geoaccess.com/oas.

If you are currently a member of CAQH, please provide your CAQH number as soon as possible in order to assure that your credentialing file can be expedited. Please make sure that your CAQH file is updated with a current attestation statement. Also, you will need to authorize Wise Provider Networks to access your information. Therefore, if your file is not set up for global authorization, you will need to login and add Wise Provider Networks.

If you have questions or require help with the process, you may contact the CAQH Help Desk at 1-888-599-1771.

If you elect not to participate with CAQH, please complete the Wise Credentialing application. Once completed, please return the completed application with all required copies and your file will be processed.

For Credentialing Questions Only - You may contact the Wise Credentialing Department at mailto:Carey@wiseprovider.net.